Individual provider Active NPI

John Denker, M.D.

  • Adult Medicine Physician
  • Portland, OR
National Provider Identifier
1942201546
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
MD 12668 Issued in OR
Practice address
5622 SE 41St Ave
Portland, OR 97202-7516
Phone
(503) 774-6929
Fax
(503) 774-6924
NPI assigned
Aug 3, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X MD 12668 OR Primary
Geriatric Medicine (Family Medicine) Physician 207QG0300X MD 12668 OR

Addresses

Primary practice location

5622 SE 41St Ave
Portland, OR 97202-7516

Mailing address

5622 SE 41St Ave
Portland, OR 97202-7516
Phone (503) 774-6929

Other identifiers 2

IdentifierTypeStateIssuer
930862374OtherTRICARE
228700MedicaidOR

Other names 1

  • John Thomas Denker Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100820000213 OR Practitioner - General Practice 0941334304 Reassigns benefits to 1 organization
Practice locations: Gresham, OR; Portland, OR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Oregon Health Sciences University School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marquis Clinical Services LLCGroup PAC ID 2860827821, 24 clinicians

Practice addresses (Care Compare)

4560 SE International Way
Suite 100
Milwaukie, OR 97222-4628
Phone (971) 206-5164

Hospital & facility affiliations

  • Marquis Vermont Hills Nursing home, Portland, OR, CCN 385218
  • Marquis Hope Village Nursing home, Canby, OR, CCN 385260
  • Marquis Centennial Post Acute Rehab Nursing home, Portland, OR, CCN 385183

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD 12668ORMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marquis Clinical Services LLC Geriatric Medicine CurrentSince Mar 26, 2024 Accepting new patients
Mt. Tabor Family Medical Group, P.C. PastSince Nov 27, 2013 Accepting new patients

Locations

4560 SE International Way
Ste 100
Portland, OR 97222
Phone (971) 206-5129

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1942201546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5622 SE 41ST AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972027516",
            "telephone_number": "503-774-6929",
            "fax_number": "503-774-6924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5622 SE 41ST AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972027516",
            "telephone_number": "503-774-6929",
            "fax_number": "503-774-6924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENKER",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-03",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "OR",
            "license": "MD 12668",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "OR",
            "license": "MD 12668",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "930862374",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "228700",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "DENKER",
            "middle_name": "THOMAS",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.